Experience of pain and lifestyle risk factors

Background Patients with acute and chronic pain have a significantly reduced quality of life, and it is a clinical impression that unhealthy lifestyle influences the experience of pain. To evaluate this, surgery can be seen as a controlled trauma and acute pain model with standardised guidelines. The aim was to investigate the association between lifestyle risk factors and experience of heavy postoperative pain and their duration after major orthopaedic surgery. Methods 109 patients undergoing spine, hip or knee surgery were included. Lifestyle was recorded as self-reported alcohol consumption, smoking, physical inactivity, obesity and risk of malnutrition based on the HPH DATA Model. Pain experience was measured on a visual analogue scale of 0-100mm for the nociceptive and the less frequent neuropathic pain. Heavy pain was defined as maximal pain >30mm at rest or 50mm as dynamic or duration of maximal pain >40min. Preoperative pain history and the methods of pain relief were noted. The postoperative pain was followed for three days. Results Univariate analyses were performed prior to the final multi-variate analyses. Interestingly, unhealthy lifestyle, age or gender were not associated with heavy postoperative pain, except for physical inactivity being negatively associated with the rare neuropathic pain. Unsurprisingly, the study confirmed the significant associations between preoperative and postoperative heavy pain. Conclusion The results showed no or very little support to the clinical impression that patients with poor lifestyle experience pain different from patients with a healthy lifestyle.